Making consent patient centred

doi:10.1136/bmj.327.7424.1159

BMJ 2003;327:1159-1161 (15 November), doi:10.1136/bmj.327.7424.1159

Education and debate

Making consent patient centred

John Bridson, acting director of studies, MSc in health care ethics¹, Clare Hammond, specialist registrar in cardiology², Austin Leach, consultant in anaesthesia and pain management², Michael R Chester, director²

¹ Unit for the Study of Health Care Ethics, Department of Primary Care, University of Liverpool, Liverpool L69 3GB, ² National Refractory Angina Centre, Cardiothoracic Centre, Liverpool NHS Trust, Liverpool L14 3PE

Correspondence to: John Bridson jbridson@liverpool.ac.uk

Taking the time to explore patients' objectives not only improvesconsent procedures but may avoid some interventions altogether

The first 150 words of the full text of this article appear below.

Guidance on obtaining patients' consent for treatment encouragesdoctors to consider their needs and priorities when disclosinginformation.¹ However, the focus on disclosure, which has arisenfrom the need to tell patients about risk, has meant not enoughattention is given to patients' objectives. To make consentproperly patient centred, clinicians need to ask patients whatthey want from treatment before they discuss treatment strategies.²We believe this approach is essential, especially in the managementof chronic illness. It should also help protect reticent patients,whose objectives may differ from the assumptions made by clinicians.

Several UK organisations have published guidance on improvingprocedures for consent in the past few years (box 1). Despitethis, the BMA's working party on consent stated that "currentawareness of the relevant ethical and legal principles relatingto consent among the medical profession is largely inadequate."³Although other initiatives have sought to improve guidance,. . . [Full text of this article]

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